National Healthcare Quality and Disparities Report
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Topics
- Access to Care (3)
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- Sickle Cell Disease (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedHudson JL, Moriya AS
AHRQ Author: Hudson JL
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
This study examined the role of marketplace policy on “welcome mat” effects for children eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Data from the American Community Survey from 2013-2018 was used to estimate the relationship between Marketplace policy and increases in Medicaid/CHIP coverage among pre-ACA eligible children after the implementation of the Affordable Care Act (ACA). The sample included non-disabled citizen children ages 0-18 at 139-250% federal poverty level who were Medicaid/CHIP-eligible before and after implementation of the ACA. Marketplace policies and enrollment were compared in expansion states versus non-expansion states. Public coverage did increase more in states that empowered their Marketplace to enroll publicly-eligible applicants directly into Medicaid/CHIP. This was driven by enrollment policy, not by choice of state-based versus federal-based Marketplaces. Welcome mats were largest in expansion states and increases ranged from 9 to 13 percentage points in enrollment.
AHRQ-authored.
Citation: Hudson JL, Moriya AS .
The role of marketplace policy on welcome mat effects for children eligible for Medicaid or the Children's Health Insurance Program.
Inquiry 2020 Jan-Dec;57:46958020952920. doi: 10.1177/0046958020952920..
Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Health Insurance, Policy, Uninsured, Access to Care
Khouja T, Burgette JM, Donohue JM
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Researchers examined whether low-income children's use of preventive dental services is linked to variation in state Medicaid policies that affect parents' access to dental care in Medicaid. Using MEPS data along with Area Health Resources File and Medicaid adult dental coverage policies, they found no change in children's receipt of preventive dental care associated with Medicaid expansions in states that covered vs did not cover preventive dental services for adults. They concluded that factors other than parental access to dental benefits through Medicaid may be more salient determinants of preventive dental care use among low-income children.
AHRQ-funded; HS026727.
Citation: Khouja T, Burgette JM, Donohue JM .
Association between Medicaid expansion, dental coverage policies for adults, and children's receipt of preventive dental services.
Health Serv Res 2020 Oct;55(5):642-50. doi: 10.1111/1475-6773.13324..
Keywords: Medical Expenditure Panel Survey (MEPS), Children/Adolescents, Dental and Oral Health, Medicaid, Health Insurance, Low-Income, Access to Care, Policy
Akincigil A, Mackie TI, Cook S
Effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children.
This retrospective observation study examined the effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children. Data was analyzed from Medicaid Analytical eXtracts (MAX) with administrative claims from 2006-2011 in Washington State. Within two years of policy implementation, prescription prevalence decreased from 6.17 to 4.04 while the synthetic control group remained stable at 6.47. The results show the effectiveness of the peer review program.
AHRQ-funded; HS026001.
Citation: Akincigil A, Mackie TI, Cook S .
Effectiveness of mandatory peer review to reduce antipsychotic prescriptions for Medicaid-insured children.
Health Serv Res 2020 Aug;55(4):596-603. doi: 10.1111/1475-6773.13297..
Keywords: Children/Adolescents, Medication, Medicaid, Policy
Bucholz EM,, Schuster MA, Toomey SL
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
This study examined trends in 30-day readmission rates for Medicaid and privately insured pediatric patients from 2010 to 2017. The HCUP Nationwide Readmissions Database was used to compare hospital-level risk-adjusted readmission rates. Higher readmission rates were found for Medicaid beneficiaires compared to privately insured pediatric patients during the time period.
AHRQ-funded; HS020513; HS025299.
Citation: Bucholz EM,, Schuster MA, Toomey SL .
Trends in 30-day readmission for Medicaid and privately insured pediatric patients: 2010-2017.
Pediatrics 2020 Aug;146(2). doi: 10.1542/peds.2020-0270..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Hospital Readmissions, Health Insurance, Medicaid, Hospitals
Taylor WM, Lu Y, Wang S
Long-term healthcare utilization by Medicaid enrolled children with neonatal abstinence syndrome.
The purpose of this study was to evaluate healthcare utilization in Medicaid enrolled children with neonatal abstinence syndrome (NAS) in the first 2 years of life. The investigators concluded that a diagnosis of NAS did not appear to be an independent predictor of increased healthcare utilization in the first 2 years of life. They indicated that their results differed from some other published studies.
AHRQ-funded; HS022941.
Citation: Taylor WM, Lu Y, Wang S .
Long-term healthcare utilization by Medicaid enrolled children with neonatal abstinence syndrome.
J Pediatr 2020 Jun;221:55-63.e6. doi: 10.1016/j.jpeds.2020.02.077..
Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Newborns/Infants, Substance Abuse
Fischer MA, Mahesri M, Lii J
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
This study examined antibiotic prescribing by clinicians when there was no visit or without clear indications for use. The authors discuss the fact that current ambulatory antibiotic stewardship policies do not capture prescribing outside of clinician visits or clear indications for use. They measured the frequency for all filled antibiotic prescriptions in Medicaid patients in the period 2004-2013. They found that out of 298 million antibiotic fills for 53 million patients (62% for children), 55% were for clinician visits with an infection-related diagnosis, 17% were for visits without an infection-related diagnosis, and 28% were not associated with a visit.
AHRQ-funded; HS024930; HS023236; HS024651; HS026506; 2332015000201.
Citation: Fischer MA, Mahesri M, Lii J .
Non-Infection-related and non-visit-based antibiotic prescribing is common among Medicaid patients.
Health Aff 2020 Feb;39(2):280-88. doi: 10.1377/hlthaff.2019.00545..
Keywords: Antimicrobial Stewardship, Medicaid, Antibiotics, Medication, Practice Patterns, Children/Adolescents
Mackie TI, Cook S, Crystal S
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
This study examined a multimodal antipsychotic intervention implemented by a specialized Medicaid managed care organization (MMCO) for youths in foster care with routine mental health screening, health passports, elective psychiatric consultation line, and retrospective drug utilization reviews to determine whether this multimodal intervention significantly reduced antipsychotic dispensing for youths with conditions without US Food and Drug Administration (FDA)-approved indications. Findings showed that MMCO implementation significantly reduced antipsychotic medications without FDA-indicated conditions prescribed to youths, while not significantly affecting antipsychotic medications prescribed to youths with FDA-indicated conditions.
AHRQ-funded; HS026001.
Citation: Mackie TI, Cook S, Crystal S .
Antipsychotic use among youth in foster care enrolled in a specialized managed care organization intervention.
J Am Acad Child Adolesc Psychiatry 2020 Jan;59(1):166-76.e3. doi: 10.1016/j.jaac.2019.04.022..
Keywords: Children/Adolescents, Behavioral Health, Medication, Vulnerable Populations, Medicaid, Health Insurance
Berry JG, Hall M, Neff J
Children with medical complexity and Medicaid: spending and cost savings.
The authors described the expenditures for children with medical complexity insured by Medicaid across the care continuum, reported the increasingly large amount of spending on hospital care for these children, and presented a business case that estimates how cost savings might be achieved from potential reductions in hospital and emergency department use and shows how the savings could underwrite investments in outpatient and community care. They concluded by discussing the importance of these findings in the context of Medicaid's quality of care and health care reform.
AHRQ-funded; HS023092.
Citation: Berry JG, Hall M, Neff J .
Children with medical complexity and Medicaid: spending and cost savings.
Health Aff 2014 Dec;33(12):2199-206. doi: 10.1377/hlthaff.2014.0828.
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Keywords: Children/Adolescents, Medicaid, Healthcare Costs, Inpatient Care, Quality of Care
Raghavan R, Brown DS, Allaire BT
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
The authors aimed to quantify the magnitude of Medicaid expenditures incurred in the purchase of psychotropic drugs for children with histories of abuse or neglect. They concluded that Medicaid agencies should focus their cost containment strategies on antidepressants and antimanic drugs, consider expanding primary care case management arrangements, and expand use of instruments such as the Child Behavior Checklist to identify and treat high-need children.
AHRQ-funded; HS020269.
Citation: Raghavan R, Brown DS, Allaire BT .
Medicaid expenditures on psychotropic medications for maltreated children: a study of 36 States.
Psychiatr Serv 2014 Dec;65(12):1445-51. doi: 10.1176/appi.ps.201400028.
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Keywords: Children/Adolescents, Healthcare Costs, Medicaid, Medication, Behavioral Health
Saloner B, Matone M, Kreider AR
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
The authors compared differences in second-generation antipsychotic utilization among Medicaid-enrolled children across fee-for-service, integrated managed care, and managed behavioral health carve-out organizational structures. They found that carve-outs, versus other arrangements, were associated with lower second-generation antipsychotic use.
AHRQ-funded; HS020269; HS018550.
Citation: Saloner B, Matone M, Kreider AR .
Second-generation antipsychotic use among stimulant-using children, by organization of Medicaid mental health.
Psychiatr Serv 2014 Dec;65(12):1458-64. doi: 10.1176/appi.ps.201300574.
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Keywords: Children/Adolescents, Healthcare Utilization, Medicaid, Medication, Behavioral Health
Beil H, Rozier RG, Preisser JS
Effects of early dental office visits on dental caries experience.
This study determined the association between timing of a first dentist office visit before age 5 and dental disease in kindergarten. It found that children with early dental visits (before age 2) had higher rates of tooth decay than those who had later visits (between ages 3 and 5).
AHRQ-funded; HS018076.
Citation: Beil H, Rozier RG, Preisser JS .
Effects of early dental office visits on dental caries experience.
Am J Public Health. 2014 Oct;104(10):1979-85. doi: 10.2105/AJPH.2013.301325..
Keywords: Dental and Oral Health, Children/Adolescents, Access to Care, Medicaid, Prevention
Vanderwerker L, Akincigil A, Olfson M
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
The researchers investigated the extent to which clinical diagnoses of externalizing disorders explain higher rates of antipsychotic use by foster care youths. They found that foster care youths had higher rates of externalizing disorders than the comparison group and greater antipsychotic use. Foster care remained a significant predictor of antipsychotic use after control for demographic and diagnostic covariates.
AHRQ-funded; HS017918; HS019937; HS021112.
Citation: Vanderwerker L, Akincigil A, Olfson M .
Foster care, externalizing disorders, and antipsychotic use among Medicaid-enrolled youths.
Psychiatr Serv 2014 Oct;65(10):1281-4. doi: 10.1176/appi.ps.201300455.
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Keywords: Children/Adolescents, Medication, Medicaid, Vulnerable Populations, Behavioral Health
Reeves S, Garcia E, Kleyn M
Identifying sickle cell disease cases using administrative claims.
The authors developed and tested the accuracy of administrative claims method for identifying children with sickle cell disease (SCD) to enable quality of care assessments among children enrolled in Medicaid. They found that their definition can be used to facilitate a more accurate identification of children with SCD in future studies.
AHRQ-funded; HS020516.
Citation: Reeves S, Garcia E, Kleyn M .
Identifying sickle cell disease cases using administrative claims.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S61-7. doi: 10.1016/j.acap.2014.02.008.
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Keywords: Children/Adolescents, Health Insurance, Medicaid, Sickle Cell Disease
Gidengil C, Mangione-Smith R, Bailey LC
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
The investigators sought to explore the claims data-related issues relevant to quality measure development for Medicaid and the Children's Health Insurance Program (CHIP), illustrating the challenges encountered and solutions developed around 3 distinct performance measure topics: care coordination for children with complex needs, quality of care for high-prevalence conditions, and hospital readmissions. Their three Centers of Excellence in pediatric quality measurement used innovative methods to develop algorithms that use Medicaid claims data to identify children with complex needs; to overcome some shortcomings of existing data for measuring quality of care for common conditions such as otitis media; and to identify readmissions after hospitalizations for lower respiratory infections.
AHRQ-funded; HS020513; HS020506; HS020508.
Citation: Gidengil C, Mangione-Smith R, Bailey LC .
Using Medicaid and CHIP claims data to support pediatric quality measurement: lessons from 3 centers of excellence in measure development.
Acad Pediatr 2014 Sep-Oct;14(5 Suppl):S76-81. doi: 10.1016/j.acap.2014.06.014.
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Keywords: Children/Adolescents, Children's Health Insurance Program (CHIP), Medicaid, Quality Indicators (QIs), Quality Measures, Quality of Care